The episode was written by Dan Greaney and directed by Jim Reardon. Joan Kenley makes her second of three guest appearances on The Simpsons in the episode as the voice of the telephone lady. It features cultural references to the world's heaviest twins, the 1993 film What's Eating Gilbert Grape, and the soft drink Tab. Since airing, the episode has received positive reviews from fans and television critics, and Empire named it the best episode of the series. It acquired a Nielsen rating of 10.0, and was the third highest rated show on the Fox network that week.

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Mr. Burns organizes a morning calisthenics program at the nuclear power plant, much to the dismay of Homer. After learning that someone who is disabled can work from home, Homer tries to find a way to achieve this goal. Homer soon discovers that any employee that weighs 300 pounds (136 kg) or more qualifies as disabled, and so he decides to gain the 61 pounds needed to reach 300. He begins eating excessively, despite Marge and Lisa's repeated warnings that he could seriously endanger his health. With Bart's help, Homer soon reaches his goal, and Mr. Burns installs a stay-at-home work terminal in the Simpson house.

Homer continues to neglect his responsibilities as a safety inspector by simply typing "yes" every time the system prompts him. Looking for shortcuts, he leaves his terminal with a drinking bird to press the Y key to indicate "yes" on the keyboard and goes out. Returning home, he discovers that the bird has fallen over, and a nuclear meltdown is imminent unless the system is manually shut down. Homer arrives at the power plant and reaches the manual shutdown button, but accidentally falls onto the gas store, blocking the release tube with the oversized lower half of his body, thus preventing the explosion. Mr. Burns gives Homer a medal and pays for him to undergo liposuction.

"King-Size Homer" was written by Dan Greaney, and directed by Jim Reardon. It was the first episode Greaney wrote for The Simpsons. Prior to this episode he was working as a lawyer and was contemplating moving to Ukraine to work for a start-up company. He said that this episode "saved" him from doing so.[2] Greaney pitched some ideas to the writing staff, but none of them were satisfactory, so then-show runner Bill Oakley gave him the idea for this episode.[2] Oakley had Greaney come to Hollywood to write it, and when Greaney showed the first draft to the staff, they liked it, so Oakley hired him.[2]

The writers wanted the title of the episode to make Homer sound proud about his weight, so they decided to name it "King-Size Homer".[3] Greaney really enjoyed working on the episode because Homer is constantly happy and goal oriented in it, instead of being a slob who is "eating all the time".[2] Animator David Silverman designed the obese Homer for the episode.[4] There was a discussion about what Homer would wear when he became fat, and they decided to go with a muumuu.[3] The writers were also discussing about how they were going to treat Homer's obesity. They did not want Homer to come off as a "hog", so they decided that the viewer should barely see him eating after he reaches his 300 pounds goal.[2] As the writers were trying to figure out a way to get Homer back to his old weight by the end of the episode, it was suggested that Homer should feel bad about his obesity, and therefore become thin for Marge, but that idea was scrapped in early production.[2] Action figurines based on obese Homer were made for the World of Springfield series shortly after the episode had aired.[5]

Homer has a dream in which he is standing at the foot of a mountain with 300 pounds as the goal at the top. A pig wearing a tuxedo appears next to him in the dream, and motivates Homer to reach the top of the mountain. This scene was inspired by the cover of the "Sweetness and Light" issue of the National Lampoon magazine.[2] The staff thought that Cary Grant would have been ideal for the pig in Homer's dream sequence, but he died nine years before the episode was made, so they used cast member Hank Azaria for that voice.[2]Joan Kenley guest starred in the episode as the telephone lady.[1] The staff flew her down from Northern California to record her part for the episode.[6]

Homer thinks that he can order the soft drink Tab by pressing the tab key on the keyboard.[3] When Homer vents gas from a nuclear reactor, the gas destroys crops of corn. A farmer says, "Oh no, the corn! Paul Newman's gonna have ma' legs broke!". This is in reference to the legend of Newman's Own popcorn products, in which Newman threatened anyone who might attempt to steal his popcorn.[5] At the cinema, Homer tries to watch the film Honk If You're Horny, starring actor Pauly Shore and actress Faye Dunaway.[7]

In its original broadcast, "King-Size Homer" finished 45th (tied with Grace Under Fire) in the ratings for the week of October 30 to November 3, 1995, with a Nielsen rating of 10.0.[8] The episode was the third highest rated show on the Fox network that week.[8]

Since airing, the episode has received mostly positive reviews from fans and television critics. In 2008, Empire placed The Simpsons at the top of their list of "The 50 Greatest TV Shows of All Time", and noted "King-Size Homer" as the show's best episode, calling it "An unimprovable mix of sharp dialogue, hilarious sight gags and heart."[9] Kimberly Potts of AOL Television named the episode the seventh best episode of the series,[10] while Michael Moran of The Times ranked it as the tenth best.[11] "King-Size Homer" appeared on The Star-Ledger's list of the ten best episodes on The Simpsons that represent the comic and emotional scope of the show.[12] The Herald Sun put the episode at ninth place on their list of the top twenty episodes of The Simpsons, and highlighted the scene in which Homer is seen "commandeering an ice cream truck in a frantic dash to the nuclear plant to avoid an impending meltdown".[13] Todd VanDerWerff of Slant Magazine named the episode the show's fifth best, stating "while there are a lot of funny jokes in this episode (including Homer's fingers that are too fat to dial), the best thing about it is the sight of Homer, weighing well over 300 pounds, dressed in a muumuu and a 'fat guy hat.' The climax is a little forced and cartoon-y...but Homer's weight gain works so well visually that the episode gets away with a lot more than it might."[14]

Dave Foster of DVD Times said: "The glee to which [Homer] takes to the challenge and the enthusiasm which Bart brings to the project show these two really do connect when the situation is oh so wrong, and the method in which the writers tackle the not-always-so-obvious downsides to such a disability are both adult and astutely amusing."[15] Jennifer Malkowski of DVD Verdict considered the best part of the episode to be during Homer's shopping trip to The Vast Waistband. The website concluded its review by giving the episode a grade of A.[16] DVD Movie Guide's Colin Jacobson enjoyed the episode and called it "one of the series' more cynical episodes", and said that it "pours on the laughs". He continued by saying, "It's amusing to see Homer's pursuit of obesity, and it exploits his idiocy well. It lacks the expected mushiness about the plight of fat folks, though it does make a point about sensitivity in an understated way."[17] Despite the numerous laughs at Homer's appearance from the staff of The Simpsons on the DVD audio commentary for the episode, the authors of the book I Can't Believe It's a Bigger and Better Updated Unofficial Simpsons Guide, Warren Martyn and Adrian Wood, wrote: "this isn't one of the best episodes. Homer's at his most irritating and childish here—you really want Marge to beat him up." They added that Homer's antics with the computer, such as the scene in which he tries to find the any key, and Mr. Burns running exercise classes are the highlights of the episode.[7]